This is a blog about Army Orthopaedic Surgeon Dr. Mark Duber and his experiences during his Afghanistan deployment. Get ready for an intense ride.

Tuesday, August 23, 2011

"Specialist O and Abbas"

Yesterday was non-traumatic and rather boring especially considering the scorching sun weighed down on me crushing my motivation; 105 degrees and humid.Today’s weather will be more of the same, but I’ll be busy indoors running an orthopedic clinic for U.S. soldiers to Afghan children.Many of the Afghan kids are handoffs from the previous orthopedic surgeon I replaced; many had significant injuries that require multiple surgeries and I’m next in line.Many of the surgeries I’ll perform while here in theater will be on the local Afghan population and a special emphasis will be on the pediatric population.Most kids are not injured as the result of this war but rather the conditions they live in which predispose them to traumatic events.After looking at my current population it is obvious that burns play a large role as most Afghan residences use a central fire pit in the middle of their homes for both cooking and heating. Kids not being taught the danger these flames present cause this scenario to capture them in serious accidental injury.High degree burns are not quick fixes either, most require multiple surgeries which usually begin with skin grafting and end with surgically treating the many associated complications.

My first patient is “Abbas” a pleasant 8 year old Afghan boy who 2 years ago fell into the flames of his family stove. He sustained significant 3rd degree burns to both of his legs which have necessitated six surgeries to date; including multiple skin grafts, a partial amputation of his right foot and associated revision surgeries.He is small for his age from my American perspective but I’m quickly learning this is the norm here in Afghanistan. He was not brought here by his mother or father as would be expected but instead by his 12 year old brother “Abfran”; he presents himself as a 25 year old man.It is immediately apparent that young adolescents in the Afghan culture are part of the backbone of their society. They are given responsibilities beyond their years which instill maturity much earlier than their American counterpart.Abfran watches my every move with scrutiny and uses out interpreter “Rocky” to decipher my intension.It hard to interact with a boy of Abfran’s age on an adult level but I am quickly learning.Abbas is doing well and I don’t foresee more surgery in his future. I pat Abbas’s shoulder, turn to Abfran and shake his hand; surprised by the testosterone in his grip, and say goodbye. They will return in 1 year for a follow-up. I also saw multiple U.S. Soldiers and another Afghan Child for routine orthopedic issues none of which needed operative intervention.

Rubes is out for the majority of this week but Joe J and I have a new guest join us for our workout; Specialist O.Specialist O is looking for direction for his desired “body transformation”. He’s young and never had sufficient athletic direction so Joe J and I are committed to bringing him on board our ship of fitness; it’s going to be a lot of work but what’s life without a challenge, especially here in Hell.Today’s routine consists of weight training our backs, abdominal work, and interval cardio training at the end.As Specialist O learned today “Intensity” is king in our routine; he never made it to the end and later informed us “I felt like I was going to puke”; we have a ways to go.Afterwards Joe J accompanied him to the DFAC (cafeteria) for lessons on eating correctly.It was Day 1 of his “body transformation” and although he did not finish were happy that he at least started; I hope he’s ready for tomorrow.

Trauma was non-existent until 6:00PM; Afghan ANA soldiers with significant injuries.I’ll fill you in tomorrow as I’m getting ready for part 2 of "marathon limb saving orthopedic surgery".